What insurance policy changes affect CPT 96133?

There are 7 tracked policy changes affecting CPT 96133, including updates from Aetna, Harvard Pilgrim Health Care, Nevada Medicaid. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 96133?

Payers that have issued tracked updates for CPT 96133 include: Aetna, Harvard Pilgrim Health Care, Nevada Medicaid, Healthfirst, Humana.

How do I get notified when CPT 96133 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 96133. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 96133?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

96133 — A healthcare provider administers and scores psychological or neuropsychological tests to assess your thinking and behavior.: Insurance Policy Changes

96133 Insurance Policy Changes

CPT 96133, in plain terms, covers A healthcare provider administers and scores psychological or neuropsychological tests to assess your thinking and behavior. CPT 96133 is referenced in 7 tracked payer policy changes from Aetna, Harvard Pilgrim Health Care, and 3 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 96133 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

High impact

Point32Health Payment Policy updates

Harvard Pilgrim Health Care·Effective Jul 1, 2026

Point32Health issued multiple payment policy updates effective 7/1/2026 affecting eight service categories across Harvard Pilgrim and Tufts Health plans. Most updates are minor administrative clarifications, but two require immediate billing changes: (1) Behavioral Health now prohibits billing psychological test codes (96130-96131) and neuropsychological test codes (96132-96133) together in the same episode of care—providers must select only the predominant service code; (2) Obstetrics/Gynecology (Tufts Health RITogether only) now allows doula service billing using specific HCPCS codes (S9445, S9446, 59510, 59400) with modifiers instead of S9445 alone.

96133 Insurance Policy Changes

Attention Deficit/Hyperactivity Disorder (CPB 0426, reviewed 2026-07-07)

Point32Health Payment Policy updates

Prior Authorization Updated in the Medicaid Management Information System for Neuropsychological, Psychological, and Developmental Testing Codes and Billing Guides Updated

Update: Telehealth flexibilities for Medicare members

Reimbursement Policies Updated in August 2026

Billing for psychological and neuropsychological testing

Psychological and Neuropsychological Testing - Medicare Advantage (New)